Ventilacion en Neonatos
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Transcript of Ventilacion en Neonatos
NEW 3.0 SOFTWARE FOR SERVO-i AND SERVO-sNEW 3.0 SOFTWARE FOR SERVO-i AND SERVO-s
NEW FUNCTIONALITY FOR SERVO-i VENTILATOR V3.0
Nasal CPAP
Y Sensor measuring
Start-up Configuration possibilities
P0.1
Patient Circuit Test
Reference loop/overlay
ALVEOLAR DEVELOPMENT
PATIENT RANGE
Adult Pediatric Neonate
TRACHEOBRONCHIAL TREE
CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP)
Delivers a pre-determined continuous pressure
Recruits collapsed alveoli
Improves oxygenation
Stabilizes the chest wall
Inhibits paradoxical movements during inspiration and collapse during expiration
CPAP
Patient Interfaces
Mask Endotracheal tube Nasal prongs
NASAL CPAP
Gives the flow necessary to maintain the pressure set by the user
5 cm H2O 5 cm H2O
NASAL CPAP
5 cm H2O 5 cm H2OContinuous flow CPAP
set flow too lowset flow too high
SERVO-i Nasal CPAP
SERVO-i
P
P
NASAL CPAP – USER INTERFACE
Standby mode:
Press:INFANT
Press: NIV
NASAL CPAP – USER INTERFACE
Selecting Nasal CPAP
Press ”Nasal CPAP”
NASAL CPAP – USER INTERFACE
Selecting Nasal CPAP
Adjust settings as necessary in the usual manner
Start ventilation
PressACCEPT to confirm
From Stand-by mode Pressto start ventilation
NASAL CPAP – USER INTERFACE
All patient-related alarms exceptO2 are inactivated
No ventilation will occur
Waiting position
NASAL CPAP – USER INTERFACE
Information if a disconnectionoccurs
Cannot resume ventilation untilexcessive leakage has beencorrected
“Leakage too high…”
NASAL CPAP – USER INTERFACE
Running Nasal CPAP mode:
NASAL CPAP – USER INTERFACE
Parameters in Nasal CPAP
CPAP
O2 concentration
NASAL CPAP – USER INTERFACE
Alarm Profile
Lower and Upper limit for CPAP alarm.
Upper pressure limit cannot be silenced permanently
NASAL CPAP – USER INTERFACE
Alarm Profile
Turning off Apnea alarm.
Turning off “apnea alarm” function
NASAL CPAP
Functions that are not available with Nasal CPAP
Volume curve
Loops
Open Lung Tool
Additional values
Additional settings
CO2
Y SENSOR MEASURING
Allows measurement of flow and pressure right upto the Y-piece
Y SENSOR MEASURING
Y Sensor measures flow and pressure
Differential pressure device – only measures and monitors
Sampling rate 100 Hz
We compare internal flow and pressure in the SERVO-i with Y Sensor measurement
Y SENSOR MEASURING
Plug and play module
Occupies 2 slots in the module compartment
Y Sensor is disposable
Neonatal/pediatric
Adult
Y SENSOR MEASURING – NEONATAL/PEDIATRIC
Dead space:<0.45 ml installed dead space
Sensor length:5.1 cm (2.0”)
Tubing length:2 meters
Sensor weight:7,5 grams
Flow measuring rate:0.125 to 40 l/min (2-667 ml/s)
Y SENSOR MEASURING - ADULT
Dead space:<9,0 ml installed dead space
Sensor length:84 mm (3.25”)
Tubing length:2 meters
Sensor weight:6.3 grams
Flow measuring rate:2 to 180 l/min (32-3200 ml/s)
Y SENSOR MEASURING
Selected patient category is compared with the connected sensor and alerts when the wrong sensor is in use.
Detects when Y Sensor measuring function is activated.
Immediately informs when the Y Sensor measuring function is deactivated.
When the Y Sensor measurement is disconnected the SERVO-i internal measurement takes over.
Y SENSOR MEASURING
Compliance compensation available
Can be used in all modes of ventilation
Pre-use check ”Y Sensor” – a new test included in the PUC and Patient Circuit Test as soon as the new software is installed.
Y SENSOR MEASURING
Y Sensor
Automatic zeroing
Purge with help of a flow to clean the pressure channels.
Only applicable for exp. Times > 1 second
Only applicable for respiratory rates < 30 breaths per minute
Y SENSOR MEASURING
Y Sensor measurements in Pressure mode
Y Sensor measurement
Y SENSOR MEASURING
Recorded waveforms measured with Y Sensor
Y Sensor measurement
Y SENSOR MEASURING
Messages – Y Sensor module is disconnected
Y SENSOR MEASURING
A message informs the user when zeroing of the Y Sensor is in progress
Zeroing in progress
Y SENSOR MEASURING
START-UP CONFIGURATION
Press to access code panel
CONFIGURATION - START-UP SETTINGS – USER INTERFACE
Key in correct access code
Press to enter “Biomed” window
CONFIGURATION - START-UP SETTINGS – USER INTERFACE
Press Edit Configuration
PressStart-up configuration
CONFIGURATION - START-UP SETTINGS – USER INTERFACE
Patient category
Invasive or Non-Invasive
Minute volume or Tidal Volume
Inspiratory time – I:E or Insp. Timein seconds (s)
Oxygen concentration in Suction Support
Press CANCEL to return to “Biomed”
Press NEXT to configure ventilation mode
CONFIGURATION - START-UP SETTINGS – USER INTERFACE
Select ventilation mode
Press to select the desired ventilation mode
Press CLOSE to return to parameter settings
CONFIGURATION - START-UP SETTINGS – USER INTERFACE
Returns you to previous window where you can check settings or make changes
To return to Standby
To continue
Returns you to factory default ventilation mode settings and parameters
CONFIGURATION - START-UP SETTINGS – USER INTERFACE
Viewing the pre-set configuration
CONFIGURATION - START-UP SETTINGS – USER INTERFACE
Restart the ventilator
CONFIGURATION - START-UP SETTINGS – USER INTERFACE
Copy configuration
CONFIGURATION - START-UP SETTINGS – USER INTERFACE
Alarm sound level
CONFIGURATION - START-UP SETTINGS – USER INTERFACE
Set default alarm sound level
CONFIGURATION - START-UP SETTINGS – USER INTERFACE
Change access code
CONFIGURATION - START-UP SETTINGS – USER INTERFACE
Invalid code
CONFIGURATION - START-UP SETTINGS – USER INTERFACE
P0.1
PO.1 is the negative pressure generated during the first 100 msec of an occluded inspiration
In patients with obstructive lung disease or acute respiratory failure, P0.1 is a useful indicator of their ability to be weaned from mechanical ventilation.
Normal value 1-2 cmH2O
P0.1
Measures all triggered breaths on an average of 8 breaths
P0.1
High P0.1 values:
Reflect an increased neuro-muscular activation of the respiratory system and therefore the development of inspiratory muscle fatigue is extremely likely.
Low P0.1 values:
Indicate successful weaning.
PATIENT CIRCUIT TEST
ADDITIONAL FEATURES
Save and compare reference loops
Current loop
Reference loop
Time for reference loop
Press to save reference loop
Overlay x 2
ADDITIONAL FEATURES
Mute and pre-mute Upper pressure limit
Maximum apnea time in infant settings changed from 15 to 45 secs
In the Suction Support disconnect phase, flow will not resume after 1 minute
High priority alarm activated after 1 min.
Time counter activated upon disconnection
Operator action indicated by a frame around the key instead of a color change
ADDITIONAL FEATURES
Increased apnea time range
Current loop
ADDITIONAL FEATURES
Suction support
Current loop
ADDITIONAL FEATURES
Current action selection
Current loop
Blue frame indicating chosen action
FEATURE ENHANCEMENTS
Additional settings – new help window
Showing some values derived from settings such as inspiration time in seconds and calculated inspiratory flow.
New help window
FEATURE ENHANCEMENTS
Trend graphs
Y sensor measuring active
new
FEATURE ENHANCEMENTS
Trend graphs (cont.)
new
FEATURE ENHANCEMENTS
Trend graphs (cont.)
new
NEW FUNCTIONALITY FOR THE SERVO-s VENTILATOR V3.0
SIMV (PC)+PS
Start-up Configuration
Patient Circuit Test
Mute and pre-mute Upper pressure limit
FiO2 trend
www.maquet.com/criticalcare
65 89 191 Rev.01 2005-05-10